Materia Medica Malaysiana

Apathy an obstacle

The number of people infected with HIV keeps going up, and Malaysia needs to intensify prevention and education efforts in HIV/AIDS work, reminded Tun Dr Siti Hasmah Mohd Ali, as nominations are called for the Dr Siti Hasmah Award which recognises excellence in HIV/AIDS work. IVY SOON reports.

BY the time the first case of HIV/AIDS was reported here in 1986, former First Lady of Malaysia Tun Dr Siti Hasmah Mohd Ali had retired from practising medicine. She was, however, well aware of the challenges in educating the public on the new epidemic as she had been involved in teaching rural women about family planning and other health issues.

The statistics on new HIV infections – which recorded an increase from three cases in 1986 to 4,597 in 1996 and to almost 7,000 last year – is worrying.

“It seems like no one is paying attention to the epidemic, if we look at the statistics. But it is not that; sometimes it is also due to individuals’ weakness. We need to talk to everyone about HIV/AIDS, not only to the youths but also older people.

“What is also worrying is the increase in heterosexual transmissions. HIV-positive (HIV+) husbands are passing the infection to their wives. So, we need to educate them on HIV prevention, on safe sex, on prevention tools,” said Dr Siti Hasmah, in stressing the need for everyone to be involved in the fight against HIV/AIDS.

As a doctor, she believes that prevention is better than cure, and education is key to prevention.

As First Lady, and chairman of the Regional Steering Committee for the Advancement of Rural and Island Women in Asia Pacific (RSC-AP), Dr Siti Hasmah has always spoken about women’s vulnerability to HIV infection.

Educating women on the disease is crucial, but Dr Siti Hasmah pointed out the need for targeted approaches.

“We have to approach women in ways that are acceptable to them. When I was introducing family planning to women in villages, and talking to them about sexual health, I found that it was not effective to talk to them in big groups in the open. It was better to talk to the women privately, sometimes one to one, or with other women family members.

“We have to explain simply and use words they can understand. We also have to persevere. It is not enough to just talk to them once. There must be follow-up (sessions), so that the women will be comfortable in asking questions.”

Condom used to be a taboo word, recalled Dr Siti Hasmah, even though it was one of the tools for family planning. “When we started teaching women about family planning, they would not even look at the condoms. The wives would think that condoms would encourage their husbands to be unfaithful; that their husbands would use the condoms with other women, not with them.”

There was no HIV/AIDS then, but now the condom has been recognised as one of the tools to prevent HIV infection. “Some people still object to the use of condoms, but we have to tell them that it is not only to protect themselves, but also to protect the children they are going to bear.”

People are more educated now than in the 1960s and 1970s, but traditions that prevail continue to render women vulnerable to HIV infections.

“We are not facing ignorance. But in many homes, men still have a say in everything. Wives must attend to their husbands’ needs, and give way to their husbands. We are concerned about mothers whose husbands are infected, with no power to say no to their husbands. Wives must have a say in their marital lives, and we need to counsel wives, who find out that their husbands are infected, on what to do to protect themselves.”

Dr Siti Hasmah is especially concerned about infected mothers – mothers who are infected by their husbands, and mothers with infected and affected children.

“This is the missing generation. When HIV+ mothers die, who will take care of their children? Prevention of mother-to-child transmission (during pregnancy and childbirth) is vital. We must prevent mothers from passing their infection to their children, but we cannot just stop with the mothers.

“It is a vicious cycle we must break. We cannot just stop at treating mothers. They get their infections from husbands, and their husbands get infected from other sources.”

The biggest obstacle in HIV/AIDS prevention work is apathy. AIDS is an infectious disease, Dr Siti Hasmah said, and we must not think that it will not happen to us. Everyone should play their role in fighting the epidemic, and an integrated approach is needed.

Hence, she hoped that the Siti Hasmah Award would inspire the public to get involved.

“We want the public and various groups, in cities and villages, to be aware of the HIV and to take it seriously. We hope for people to be more involved in prevention efforts. We need the media and other groups to disseminate information on HIV because education is important.

“The recipient of the last Dr Siti Hasmah award was a person living with HIV/AIDS, and we hope to recognise more infected individuals. We want to highlight how they help prevention efforts by going public about their condition so people also see the positive side of HIV/AIDS.”

The Dr Siti Hasmah Award was established in 1996 by the Malaysian AIDS Foundation (MAF) and highlights outstanding contributions made by organisations and individuals in addressing HIV/AIDS in Malaysia. Winner of the award, given biennially, will take home a trophy, cash prize of RM10,000 (organisation) or RM5,000 (individual), and a certificate of excellence.

Two Special Mention Awards will also be presented, one for prevention education and another for care and support.

Today is the last day for submitting nominations for the award. More information and entry forms can be found at www.malaysianaidsfoundation.org.my, or call Azita Azlan at 03-40451033.